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I am 18 years old with a sagging, jowly face. What are my options?

When I was 15 years old I had a severe sport injury that caused a mini stroke and resulted in facial sagging. I have deep lines over my mouth, heavy jowls, and my eyes and cheeks are dragged down. This has been very distressing; people often think I'm in my 30's- I'm 18! Dealing with this causes a great deal of anxiety. What are my options? It seems I would need a very dramatic full facelift to reclaim my youth, when I pull back my skin in the mirror.

Doctor Answers (7)

Modified unilateral facelift for facial palsy

+1
Although you're very young to consider a facelift, your situation is unique in that you have had an apparent facial palsy secondary to a neurologic event.

It would be very important for you to seek consultation with your primary care doctor or neurologist to refer you to a plastic surgeon for a reconstructive procedure.

A unilateral or one sided facial tightening can certainly be done in patients who have weakness or paralysis on one side of the face which causes sagging around the mouth and jaw line.


Boston Plastic Surgeon
5.0 out of 5 stars 36 reviews

Facelift Options for Sagging, Jowly Face

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You should proceed by having in-person evaluations with multiple well-respected surgeons who can give you an honest opinions and the most appropriate advice based on your individual circumstances.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

You need an exam

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Without photos it is impossible to evaluate what is bothering you. 18 is awfully young for a facelift.  If you have facial nerve damage, you might need a flap or graft.  You need a full, live examination by an expert. 

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

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Drooping face as a teen?

+1
Your history is quite complex and you simply need to see a local doctor who can get you pointed in the right direction as to what will provide you with the best results possible.  The plan will vary considerably by what your real problem is.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

Sagging tissues after sports injury

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  • It is likely you have an injury to the nerves that move the face,
  • Nerve branches in the face may be injured or the nerve may be injured within the brain,
  • You need both a Board Certified Plastic Surgeon or ENT Surgeon experienced in facial surgery and 
  • a neurologist to determine the level of the injury,
  • Facial nerve injuries in the face can sometimes be repaired well after the injury,
  • Injuries to the nerve origins in the brain cannot, 
  • Scans if not already done to determine what bone damage there may be,
  • Then the discussion is what facial surgery can be done to restore your appearance.
  • It will take a while to find the right surgeons but there is hope. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.5 out of 5 stars 22 reviews

Facial drooping

+1
It seems as though you may have facial nerve weakness and/or displacement of soft tissues from the trauma.  In my experience, evaluation of the deformities is extremely important, and may involve looking at the bones (i.e. CT scan) as well as the soft tissue displacement to determine the best approach, especially if there is any facial nerve weakness.  Seek consultation with a facial surgeon experience in both reconstructive and cosmetic techniques, as it is likely that the procedures recommended will require a combination of both.  The specialty is far less important than the expertise and experience of the surgeon.

John Frodel, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Age and facelift surgery

+1
Your problem is very unique.   While the facelift in general is not something for an 18 year old you may be an exception.  You need to see 3 surgeons who do a lot of facial surgery and have them make recommendations, for you.   Be sure and see ABPS surgeons who are also FACS.  You need to see seasoned surgeons.  You may be correct that some aesthetic surgery is indicated.   If this has been caused by an accident you likely will be covered by insurance so explore this option to the absolute max.  You might also consider going to your local university plastic surgery service to have an evaluation.  My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.